ATI RN
Pediatric Nursing Cardiovascular Disorders Questions
Question 1 of 5
A client with pheochromocytoma reports the onset of a severe headache. The nurse observes that the client is very diaphoretic. Which assessment data should the nurse obtain next?
Correct Answer: A
Rationale: In this scenario, the correct assessment data the nurse should obtain next is blood pressure (Option A). Pheochromocytoma is a catecholamine-secreting tumor that can cause severe hypertension, leading to symptoms such as severe headaches and diaphoresis. Monitoring the client's blood pressure is crucial in this situation to assess for hypertensive crisis, which can be life-threatening if not managed promptly. Blood glucose level (Option B) is not the priority in this case as the client's symptoms are more indicative of a cardiovascular issue related to pheochromocytoma rather than a metabolic issue. Respiratory rate (Option C) and oxygen saturation (Option D) are important assessments, but in this context, the client's presentation of severe headache and diaphoresis points more towards a cardiovascular concern related to the pheochromocytoma. However, respiratory rate and oxygen saturation should still be monitored as part of the overall assessment. Educationally, understanding the specific signs and symptoms of pheochromocytoma and related cardiovascular disorders in pediatric patients is crucial for nurses working in pediatric settings. This rationale highlights the importance of prioritizing assessments based on the client's presenting symptoms to provide timely and appropriate care.
Question 2 of 5
A male client with chronic kidney disease (CKD) is beginning his first hemodialysis 3 times per week. Which short-term goal is most important for the nurse to include in the plan of care for this client as he begins the series?
Correct Answer: D
Rationale: In the context of a male client with chronic kidney disease (CKD) starting hemodialysis, the most important short-term goal is for the client to verbalize an understanding of the reasoning for dialysis (Option D). Understanding the need for dialysis is crucial for treatment adherence and self-management. Option A, reporting subjective symptoms during hemodialysis, is important but not as critical as understanding the rationale for the treatment. Option B, documenting oral intake during dialysis, is important for fluid management but not as immediate as understanding the purpose of dialysis. Option C, demonstrating self-care of the AV Shunt, is essential but comes after understanding the need for dialysis. Educationally, emphasizing the rationale behind treatments helps clients engage in their care, adhere to treatment plans, and make informed decisions. It empowers patients to actively participate in their health management, leading to better outcomes and improved quality of life. Understanding the purpose of dialysis is foundational for a client starting this life-saving treatment.
Question 3 of 5
The nurse calculates the body mass index (BMI) for an obese adult. Which additional assessment finding places the client at high risk for cardiac disease?
Correct Answer: A
Rationale: In pediatric nursing, understanding the relationship between obesity and cardiovascular risk factors is crucial. In this scenario, option A, "Large waist circumference with central fat," is the correct answer. Central obesity, often indicated by a large waist circumference, is a significant risk factor for cardiac disease. Excess visceral fat around the abdomen is associated with insulin resistance, inflammation, and dyslipidemia, all contributing to cardiovascular complications. Option B, "High serum insulin level," while indicative of metabolic dysfunction in obesity, is more directly related to diabetes risk rather than specifically cardiac disease in this context. Option C, "Hyperpigmentation on neck skin folds," is a sign of conditions like acanthosis nigricans, which is associated with insulin resistance and obesity-related metabolic issues rather than cardiac disease specifically. Option D, "Poor muscle tone," is not directly linked to cardiac disease risk in the context of obesity. While physical inactivity related to poor muscle tone can contribute to cardiovascular issues, central obesity is a more significant and direct risk factor in this scenario. Educationally, this question helps pediatric nursing students understand the importance of assessing obesity-related risk factors for cardiovascular disease in pediatric patients. Understanding these relationships is crucial for providing holistic care and early interventions to prevent long-term complications related to obesity in children.
Question 4 of 5
An adult client is admitted with diabetic ketoacidosis (DKA) and a urinary tract infection (UTI). Prescriptions for intravenous antibiotics and an insulin infusion are initiated. Which serum laboratory value warrants the most immediate intervention by the nurse?
Correct Answer: D
Rationale: In this scenario, the most immediate intervention by the nurse should be directed towards the serum potassium level of 2.5 mEq/L (Option D). This low potassium level, known as hypokalemia, poses the most immediate threat to the client's health due to the potential for serious cardiac complications such as arrhythmias and cardiac arrest. The other options are not as critical as hypokalemia in this situation: - Option A: A glucose level of 350 mg/dl is high but is a common finding in diabetic ketoacidosis and can be addressed through insulin therapy. - Option B: A white blood cell count of 15,000 mm3 indicates infection but is not as immediately life-threatening as severe hypokalemia. - Option C: A blood pH of 7.30 is slightly low but is a common finding in diabetic ketoacidosis and can be managed along with the insulin infusion. Educationally, this question highlights the importance of prioritizing interventions based on the client's condition and potential complications. Understanding the significance of electrolyte imbalances in critically ill patients is crucial for nurses caring for clients with complex health issues like diabetic ketoacidosis and infections.
Question 5 of 5
The nurse is preparing a client for discharge who was recently diagnosed with Addison's disease. Which instruction is most important for the nurse to include in the client's discharge teaching plan?
Correct Answer: D
Rationale: In the context of pediatric nursing and cardiovascular disorders, understanding the management of Addison's disease is crucial. The correct answer is D) Take prescribed cortisone accurately. This instruction is paramount because Addison's disease results from adrenal insufficiency, leading to decreased cortisol production. Cortisone replacement therapy is essential to manage the condition and prevent adrenal crisis. Option A) Use a walker when weakness occurs is incorrect as it does not address the primary treatment for Addison's disease. Option B) Avoid extreme environmental temperatures is important for some conditions but is not the priority in Addison's disease management. Option C) Increase daily intake of sodium in the diet is relevant for Addison's disease due to mineralocorticoid deficiency, but ensuring proper cortisone replacement is the primary focus. In an educational context, it is vital for pediatric nurses to prioritize teaching accurate medication administration to children with chronic conditions like Addison's disease. Emphasizing the significance of adherence to cortisone therapy can prevent life-threatening complications and empower patients and families to manage the condition effectively.